Le d�but des compromis compromettant Un monument aux intentions Une lueur d'espoir La particpation du publique (les gens) et du priv� par des lev�s de fonds ! ?
Question : Il y'a eu des lev�es de fonds pour le m�gaH�pital � Paris ? Charles Brault EMT-P Montr�al - Pas de m�gah�pitaux avant 2010 Couillard veut r�examiner le financement, les sites et l'�ch�ancier Marie-Andr�e Chouinard �dition du mardi 22 juillet 2003 Mots cl�s : Qu�bec (province), Montr�al, sant�, H�pital, m�ga-h�pital Remise � neuf pour les deux projets de centres hospitaliers universitaires � Montr�al: le gouvernement lib�ral les relance mais reporte l'�ch�ancier pr�vu, r�duit le portefeuille demand� et remet en question le choix des sites privil�gi�s pour leur �rection future. Pass�s sous la lorgnette de l'administration lib�rale, les projets du Centre hospitalier de l'Universit� de Montr�al (CHUM) et du Centre universitaire de sant� McGill (CUSM) prendront forme en 2010, et co�teront 800 millions chacun au gouvernement. Apr�s avoir fait l'objet de nouvelles analyses par les centres hospitaliers eux-m�mes, qui prennent d�sormais la gouverne de l'entreprise, les projets voient leur sort remis entre les mains du conseil des ministres qui sera appel� � trancher au printemps 2004. Pour �mettre fin � l'incertitude qui a �t� trop longtemps maintenue dans le dossier des centres hospitaliers universitaires de Montr�al�, le ministre de la Sant� et des Services sociaux, Philippe Couillard, a fix� hier les balises de ce projet, qu'il souhaite associer � plus �qu'une construction de b�ton� et agr�menter d�sormais d'une �philosophie int�gr�e�. Convoquant la presse au plus fort des vacances estivales, le ministre Couillard a expos� les param�tres qu'il souhaite voir respect�s par les deux �quipes dans la pr�sentation de leur projet. Si les plans initiaux pr�voyaient le d�marrage des activit�s de ces deux �tablissements en 2006, elles sont d�sormais report�es � 2010. Alors que les besoins financiers avaient �t� �valu�s � 2,3 milliard, on ne parle plus d�sormais que de 1,6 milliard de contribution publique. Et le ministre exige que les nouvelles r�flexions comprennent la remise en question des sites privil�gi�s -- le 6000, rue Saint-Denis dans le cas du CHUM, et le site Glen dans le cas du CUSM. �Les choix du site Glen et du site Saint-Denis devront faire l'objet d'un examen plus approfondi � la lumi�re de nouvelles donn�es et de la connaissance plus pr�cise de certaines contraintes�, a expliqu� Philippe Couillard, pr�cisant ensuite ses inqui�tudes et enjoignant aux h�pitaux de pr�senter des plans B, �hypoth�ses de construction ou de r�novation moins co�teuses ou risqu�es�. La proximit� d'une voie ferr�e aux abords du site Saint-Denis indispose le ministre, qui craint les �cons�quences catastrophiques� en cas de d�versement toxique par exemple. De m�me, les difficult�s d'acc�s au site Glen devront �tre effac�es pour r�ussir le test de l'accessibilit� routi�re, a pr�cis� le ministre. Une analyse de faisabilit� quant au choix des sites devra �tre formul�e par les deux centres, en accord avec le minist�re des Transports, celui de la S�curit� publique et la Ville de Montr�al, et pr�sent�e au minist�re avant la mi-novembre. �Quant � nous, l'adresse du nouveau CHUM est le 6000 Saint-Denis�, r�pliquait hier le pr�sident du conseil d'administration du CHUM, Patrick A. Molinari. �Nous n'avons pas formellement de plan B�, ajoute-t-il, par ailleurs ravi des annonces faites hier, qui permettent �au CHUM d'aujourd'hui de d�terminer ce que sera le CHUM de demain�. Du c�t� de McGill, la question du site est d'autant plus d�licate que le gouvernement du Qu�bec a r�cemment achet� le site Glen pour y loger le futur centre hospitalier universitaire. �Le ministre dit qu'il veut avoir des �tudes sur la question de l'acc�s routier, nous les avons, nous lui soumettrons�, explique le Dr Nicolas Steinmetz, directeur g�n�ral adjoint du bureau de planification du CUSM (Soci�t� d'implantation du CUSM), lui aussi satisfait du �plan coh�rent et clair� pr�sent� hier. �Nous sommes capables de d�montrer qu'il n'y a pas de probl�me majeur, mais dans notre cas, le site est d�j� achet�, pr�cise-t-il, avouant au passage que le CUSM n'a pas non plus de plan B dans ses cartons, tel que le ministre l'�voquait hier. Flanqu� de la pr�sidente du Conseil du tr�sor, Monique J�r�me-Forget, le ministre de la Sant� a pr�cis� que les param�tres des nouveaux h�pitaux pr�voyaient une enveloppe de 800 millions chacun fournie par Qu�bec, en plus d'une enveloppe minimale de 200 millions par projet issue des fondations, des contributions priv�es et des fonds f�d�raux. Les nombreuses tergiversations qui ont entour� la cr�ation de ces deux nouveaux h�pitaux ont fait �tat de besoins financiers de 1,3 milliard pour le CUSM, et d'un milliard au moins pour le CHUM. �Nous attendions des montants clairs, c'est la premi�re fois qu'on en a�, a r�agi Me Molinari. �On parle encore d'un milliard, mais avec une configuration diff�rente.� Du c�t� de McGill, la hauteur du portefeuille semblait indisposer davantage. �Nous allons voir ce qu'on peut faire avec �a�, expose le Dr Steinmetz. �N'oublions pas qu'on ne nous emp�che pas d'investir plus si on trouve les �pargnes n�cessaires.� Les deux centres universitaires vont par ailleurs mettre en commun les sommes recueillies aupr�s des entreprises lors de campagnes de financement communes, a confirm� le Dr Steinmetz, pour ensuite les diviser en parts �gales, ce que le ministre Couillard a pr�sent� hier comme une avanc�e remarquable. Mille lits seront d�volus au CHUM, contre 832 pour le CUSM. Ces donn�es, moindres que ce qui avait �t� �voqu� auparavant, comprennent les lits maintenus pour un h�pital compl�mentaire au centre-ville, que les deux nouveaux �tablissements doivent inclure � leur projet. S'ils doivent eux-m�mes se concentrer sur les soins tertiaires et quaternaires, �tout en d�laissant une partie des services de niveaux 1 et 2 aux autres �tablissements hospitaliers�, les deux nouveaux h�pitaux auront une salle d'urgence. On exige aussi qu'ils maximisent l'utilisation de leurs b�timents �r�siduels�, et la R�gie r�gionale de Montr�al-Centre -- ou l'entit� qui la remplacera -- devra se pencher sur les incidences qu'auront ces nouvelles structures sur les besoins et les services de 1re et 2e lignes � Montr�al, en s'attardant par exemple � l'�pineuse question de l'engorgement des urgences. Les nouveaux param�tres d�finis hier par le ministre comprennent en outre la dissolution imm�diate des deux soci�t�s d'implantation qui planchaient sur les projets depuis 2000. � ce jour, leurs travaux laissent une facture globale de 54 millions, qui sera toutefois ins�r�e aux d�penses gouvernementales totales de 1,6 milliard. �Des rencontres sont pr�vues avec les gens du CHUM sous peu, pas de commentaires d'ici l�, a expliqu� hier Christiane Th�berge, directrice des communications pour la SICHUM, que le gouvernement Charest efface du paysage. L'�ch�ancier pr�vu pour la remise des projets est de f�vrier 2004. Une commission technique ind�pendante -- dont la composition sera connue � l'automne -- sera charg�e de l'examen des propositions et fera ses recommandations au ministre au printemps de la m�me ann�e. Wednesday � July 23 � 2003 Superhospitals trimmed $800 Million each. Health minister has qualms about sites; Montreal General likely to have role JANET BAGNALL The Gazette CREDIT: JOHN KENNEY, GAZETTE At his news conference yesterday, Health Minister Philippe Couillard said it is "not safe" to have only two superhospitals in Montreal. The Liberals want each to have a second "complementary" hospital. In the case of the McGill University Health Centre, that hospital is expected to be the Montreal General. CREDIT: JOHN KENNEY, GAZETTE Despite Quebec's concerns, Nicolas Steinmetz of the McGill University Health Centre maintained yesterday that there aren't any problems with the Glen Yard site: "We don't see any difficulties." Montreal will have two new hospitals, the Charest government announced yesterday, but the maximum they will get from the province's coffers is $800 million apiece. As well, in a repudiation of the "superhospital" concept developed under the previous government, Health Minister Philippe Couillard said it is "not safe" to have only two hospitals in Montreal. The new health-care networks will have to each include a second "complementary" hospital. In the case of the McGill University Health Centre, that hospital is expected to be the Montreal General. The government is also insisting the two new hospitals each raise an extra $200 million from the federal government and private-sector sources before being allowed to go ahead. Originally, the budgets for the two superhospitals were put at $1.1 billion apiece. As recently as last summer, the McGill University Health Centre was hoping for $2 billion in funding from the province alone. Nothing about the previous superhospital projects appeared to have met with unalloyed enthusiasm from the incoming government, including the sites chosen for the new hospitals. Couillard cited "serious" problems with both sites, the St. Denis St. site for the Centre hospital de l'Universit� de Montr�al and the Glen Yard site for the McGill project. The minister was worried by the proximity of train tracks to the St. Denis St. site, saying no plans have been drawn up to deal with a toxic spill. He also pointed out that acquisition costs of the site and the work of decontaminating it could prove expensive. In the case of the Glen Yard, expensive road work would have to be done to facilitate access to the new facility. Experts have said the cost could run to $100 million. (The road infrastructure work would not be part of the $800-million budget.) Both university health centres must report to the minister on these problems by Dec. 15. Nicolas Steinmetz, associate executive director of the Children's, said he expects to submit a report earlier than this because much of the technical analysis of the Glen Yard site has been done. He said a number of technical studies were not given to the Parti Qu�b�cois government because it didn't ask for them. An independent technical commission appointed by the Liberal government to oversee planning of the new hospitals will table its report and recommendations by February. At that point, Couillard will make his recommendations to cabinet. Realistically, he said, the new hospitals will not be operating before 2009 or 2010. The number of proposed beds has remained roughly the same under the current government guidelines. There will be a total of 832 in the McGill University network, including pediatric beds and the beds in the secondary hospital. This represents a loss of more than 220 beds from the current number, spread among the Royal Victoria Hospital, the General, Montreal Children's Hospital, Montreal Neurological Institute and Montreal Chest Hospital. It is, however, the same number as proposed for the superhospital. The minister said the Shriners Hospital for children might move onto the site of the new hospital, following talks with Premier Jean Charest. The Shriners, a recognized centre of expertise with hospitals across North America, wants to build a larger hospital near McGill's new teaching facility. The government has agreed to a total of 1,000 beds for the Centre hospitalier de l'Universit� de Montr�al's new hospital. This number would include beds in a secondary hospital, but not pediatric beds. Couillard also announced yesterday the Liberal government will participate in the modernization of Ste. Justine Hospital. To begin with, it will give Ste. Justine $500,000 to evaluate its technical and operating needs. Speaking at a news conference in downtown Montreal, Couillard said he does not view the two hospital networks as either francophone or anglophone. He acknowledged the city's English-speaking community has a particular attachment to its hospitals, but said that a large number of doctors and patients in anglophone hospitals are francophone. He said that there is already a lot of "complementarity" between the city's two pediatric hospitals, the Children's and Ste. Justine's. He also praised a proposed joint, corporate fundraising campaign by McGill and Universit� de Montr�al as a sign of a new era in linguistic relations in Quebec. Couillard said his government has two goals in building the new hospitals: one is to ensure that Montrealers have access to medical care; the second is to see Montreal become a world centre for medical research and teaching. "We are dealing with a shortage of medical manpower," Couillard said. In the current situation, the minister said, the two main teaching centres "cannibalize" each other, vying to hire each other's top researchers or practitioners. The new hospitals' mandate is not to be all things to all patients. A Critical List of Dates 1991 Nicolas Steinmetz, executive director of the Montreal Children's Hospital, proposes a new health centre to replace McGill University's five teaching hospitals (the Montreal General, Royal Victoria, Chest, Children's and Neurological Institute). 1992 Over the next decade, seven health ministers have the superhospital file on their desks. Although none approves the funds required, they all embrace the claim that these facilities are necessary. 1994 McGill officially adopts a policy to pursue a superhospital. The university receives $6 million from the Liberal government to plan for the new facility. It later gets another $13 million from the Parti Qu�b�cois government. 1995 Jacques Genest, founder of the Institut de recherches cliniques de Montreal, proposes a French superhospital to replace Notre Dame, St. Luc and H�tel Dieu hospitals. 1997 McGill forms the McGill University Health Centre, a single administrative unit to run all existing hospitals and to plan its superhospital. 1999 Premier Lucien Bouchard's PQ government decides to explore building a superhospital for the Universit� de Montr�al. 2000 The Soci�t� d'implantation du Centre hospitalier de l'Universit� de Montr�al is set up. A site is chosen at St. Denis St. and Van Horne Ave., near the Rosemont m�tro station and the Montreal transit commission's bus depot. At the time, the hospital's cost is estimated at $860 million. 2001 The provincial government purchases the Glen Yard site for the MUHC superhospital from CP for $18 million. Later, it is revealed that it will cost at least $33 million to decontaminate the site and not the originally estimated $4 million. 2002 The MUHC and CHUM set up a task force to consider cost sharing and group purchasing. Sharing surgical equipment, buying the same computer systems and setting up a central laundry are among the ideas considered. 2003 In March, PQ Health Minister Fran�ois Legault says he needs more time and more information before making a decision on funding for the MUHC and CHUM superhospitals. Cost estimates have already surpassed each hospital's $1-billion budget. On April 14, the Liberals defeat the Parti Qu�b�cois in a provincial election. On May 8, Jean Charest, the new Liberal premier, says his government is committed to building the superhospitals, but he's not sure where the money will come from. On July 21, Health Minister Philippe Couillard announces that Montreal will have two new hospitals, but they will get only $800 million apiece from the province. As well, the new health-care networks will have to include a second "complementary" hospital for each of the superhospitals. By Dec. 15, both university health centres must report to the health minister on how to deal with problems posed by the two selected construction sites. 2007 This is the year superhospital planners had hoped to open both hospitals. 2009 or 2010 Years that are more realistic for the new hospitals to be operating, the health minister says. � Copyright 2003 Montreal Gazette Copyright � 2003 CanWest Interactive, a division of CanWest Global Communications Corp. All rights reserved. Optimized for browser versions 4.0 and higher. __________________________________ Do you Yahoo!? Yahoo! SiteBuilder - Free, easy-to-use web site design software http://sitebuilder.yahoo.com --- URG-L Aimeriez-vous obtenir une adresse de courriel @URGENCES.CA? Suivez-le lien http://www.groupegiroux.com/messagerie pour de plus amples informations.
